Ischemic heart disease is caused by a lack of oxygenated blood flow to the heart muscle. The most common cause is coronary atherosclerosis which narrows or blocks the coronary arteries. This leads to myocardial ischemia and can result in angina, heart attack, or sudden cardiac death if left untreated. Heart attacks are specifically caused by prolonged ischemia and damage to the heart muscle. Risk factors include hypertension, smoking, obesity, high cholesterol, and diabetes. Diagnosis involves evaluating symptoms, cardiac enzyme levels, electrocardiogram changes, and imaging tests. Prompt treatment is important to limit damage to heart muscle.